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Platelets Cellular and Functional Characteristics in Patients with Atrial Fibrillation: A Comprehensive Meta-Analysis and Systematic Review

Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Anton Sabashnikov, Aron-Frederik Popov, Seyed Jalil Mirhosseini, Luis Nombela-Franco, Luca Testa, Mohammadreza Lotfaliani, Mohamed Zeriouh, Tong Liu, Hamidreza Dehghan, Senol Yavuz, Michel Pompeu Barros de Oliveira Sá, William L. Baker, Jae-Sik Jang, Mengqi Gong, Umberto Benedetto, Pascal M. Dohmen, Fabrizio D'Ascenzo, Abhishek J. Deshmukh, Giuseppe Biondi-Zoccai, Hugh Calkins, Gregg W. Stone, Integrated Meta-Analysis of Cardiac Surgery and Cardiology-Group [IMCSC-Group]

Department of Cardiac Surgery, University Hospital Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany

Med Sci Monit Basic Res 2017; 23:58-86

DOI: 10.12659/MSMBR.902557

Available online: 2017-03-17

Published: 2017-03-17


BACKGROUND: This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of platelet cellular and functional characteristics including platelet count (PC), MPV, platelet distribution width (PDW), platelet factor 4, beta thromboglobulin (BTG), and p-selectin with the occurrence of atrial fibrillation (AF) and consequent stroke.
MATERIAL AND METHODS: We conducted a meta-analysis of observational studies evaluating platelet characteristics in patients with paroxysmal, persistent and permanent atrial fibrillations. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity.
RESULTS: Literature search of all major databases retrieved 1,676 studies. After screening, a total of 73 studies were identified. Pooled analysis showed significant differences in PC (weighted mean difference (WMD)=–26.93 and p<0.001), MPV (WMD=0.61 and p<0.001), PDW (WMD=–0.22 and p=0.002), BTG (WMD=24.69 and p<0.001), PF4 (WMD=4.59 and p<0.001), and p-selectin (WMD=4.90 and p<0.001).
CONCLUSIONS: Platelets play a critical and precipitating role in the occurrence of AF. Whereas distribution width of platelets as well as factors of platelet activity was significantly greater in AF patients compared to SR patients, platelet count was significantly lower in AF patients.

Keywords: Atrial Fibrillation, Blood Coagulation, Platelet Count